Why I feel for that doctor who ranted about A&E time-wasters

Dr Christian Solomonides, a consultant in a busy London A&E department, set up a Twitter account on which he posted dozens of expletive-ridden messages about his experiences

Suppose you’re a doctor in A&E. You are eight hours into your shift when the door to the ambulance bay swings open and a young boy is rushed in on a trolley.

He’s been hit by a car. He has multiple fractures and is bleeding profusely.

As the senior doctor in the department, you’re ready to fight to save him, but he has a cardiac arrest and dies before you can do anything.

His parents are in pieces as you break the news to them. You then write up the notes and, ten minutes later, are back out in the department.

The next person you see has called an ambulance because they have stubbed their toe. When you explain there’s nothing wrong and ask them to leave, they become aggressive and you have to call security.

What would you feel about this time-waster? Probably a mixture of disbelief and pure rage. Yet this is exactly the kind of scenario those working in A&E have to deal with every day.

I’ve spent many years in casualty, covering mental health, and have seen the utterly disgraceful way this precious resource is abused.

The sheer volume of time-wasters would horrify you, as would the aggression and hostility those at the coalface endure. Is it any wonder they sometimes need to vent their spleen?

Dr Christian Solomonides, a consultant in a busy London A&E department, set up a Twitter account on which he posted dozens of expletive-ridden messages about his experiences.

This week, after someone complained about the posts — which Dr Solomonides mistakenly thought were private — he was hauled before the General Medical Council for a disciplinary hearing and faced losing his career.

I’m pleased to say that yesterday he escaped being struck off. But he was found guilty of misconduct and suspended for two months.

The truth is he should never have endured this ordeal at all. Because reading his tweets, it’s hard not to agree with most of them.

Yes, he makes deeply inappropriate comments about religion. And he expresses his opinions in blunt and often offensive ways.

Nevertheless, he shines a light on the daily realities of his job.

In fact, I doubt a single person who’s ever worked in A&E would disagree with his analysis.

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In one tweet, Dr Solomonides writes: ‘If you are well enough to rant and rave at hard-working staff, you are probably well enough to NOT require emergency care’.

Oh, if only it were simply rudeness: I’ve been punched, kicked, slapped, spat at, had death threats, twice had a knife pulled on me and once been held hostage. Someone even stormed in brandishing a gun. Sadly, ranting isn’t the half of it.

Dr Solomonides also tweets about being overworked: ‘Being pulled left right and centre here.’

Well, he’s clearly not alone: there is a recruitment crisis in A&E with 50 per cent of training posts unfilled. One in five consultant posts is empty and there’s a heavy reliance on hugely expensive locum staff. Burnout rates are exceptionally high.

On time-wasters, Dr Solomonides is spot on. Three years ago, he tweeted: ‘It costs £1,000 to deploy an ambulance and convey to hospital, I would say that 90% of call outs are f****** bull****.’

Yes, he could have phrased it more delicately, but some people think ambulances are extra-fast taxis with flashing lights. In reality, they are incredibly expensive and staffed by expert professionals.

When one is called out for a broken nail or some other ridiculous reason, there’s one less available to save a life. It’s estimated about 80 per cent of all ‘blue light’ (urgently deployed) ambulances are not needed.

There is a recruitment crisis in A&E with 50 per cent of training posts unfilled. One in five consultant posts is empty and there’s a heavy reliance on hugely expensive locum staff, writes DR MAX THE MIND DOCTOR

Dr Solomonides also tweeted about the frustration of calling for a patient to come in for examination, only to be told they’ve ‘just popped out for a fag’. Oh, how common this is.

If someone is able to go outside to smoke, it’s unlikely they’re in such a bad way that they require urgent treatment. Certainly they are not going to be prioritised over people who can’t breathe, let alone smoke.

Dr Solomonides suggests that a £50 fine for time-wasters ‘will soon drive away the droves of ambulatory neurotics’. Perhaps unsurprisingly, this idea is very popular with A&E staff.

While I’d have happily fined the young man who came to A&E demanding that I help him get a better flat off the council, I’m not convinced the penalty is a good idea as it might deter genuinely sick people from seeking help.

However, it’s a perfectly valid point to raise, and why shouldn’t Dr Solomonides suggest it?

I’m deeply disturbed that this case ever came before the General Medical Council. In recent years, the GMC — an unelected and unaccountable quango — has shown an increasing readiness to restrict doctors’ free speech under the vague charge of ‘bringing the profession into disrepute’.

Effectively, they’re turning into a medical thought police. If they don’t like your opinion and someone complains, you’re in trouble, as Dr Solomonides has found out.

Let’s remember that what he wrote was done anonymously and there was no breach of patient confidentiality. Yes, he was rash, daft and in some instances deeply offensive.

But he’s entitled to his opinions. We should be saving our opprobrium for those who misuse the A&E units we all, one day, may desperately need.

A disgrace, but no paedophile

So England footballer Adam Johnson is awaiting sentence, and has been told to expect a long custodial stretch. Good.

What he did was a disgraceful abuse of his power. He took a young, vulnerable and naive girl and exploited her for his carnal desire. He deserves all he gets.

But can we stop calling him a paedophile? The girl was 15. A paedophile, by the definition of the word, is an adult sexually attracted to prepubescent children.

While this is generally considered to mean children of 11 and younger, for a medical diagnosis it is sometimes extended to 13.

But the key feature is an attraction to pre-sexual bodies. That is simply not the case with Johnson. This is not mere semantics: it’s very important. Paedophilia is a psychiatric illness. The sexual attraction is pathological.

Conflating Johnson’s actions with those of a paedophile risks blurring the true, horrific sickness of child abusers. But more than this, it prevents us from recognising the calculated, callous amorality of everyday predators like him.

Johnson isn’t sick, he’s arrogant. He treated the age of consent like the offside rule — a minor inconvenience you can break if the linesman isn’t watching.

New figures reveal almost half of expectant mums are overweight or obese — putting them at risk of miscarriage and birth complications.

But I find the statistic shocking for a different reason: those overweight mums are much more likely to have overweight children. We know obesity runs in families because parents pass on their bad eating habits.

More than a third of UK children are overweight or obese. Even worse, evidence suggests that if you’re overweight as a child, you’re very unlikely ever to attain a normal weight as an adult.

So, fat mums are basically condemning their babies to a life of obesity, with all the ill health that comes with it. How selfish can you get?

Cat killer could attack a child next

Something very disturbing is going on in Croydon. I was there a few weeks ago to see my godchildren, and their parents asked if I’d heard about the Croydon cat killer.

It’s the talk of the area and is so horrific it’s now started to make national news.

The bodies of more than ten headless cats have been found dumped over the past few months — one of them, Ukiyo, is pictured below. It’s thought they’ve been deliberately hit by a car and then mutilated, including being decapitated and having their tails cut off.

One animal shelter believes the number of murders may be as high as 50. Mutilated rabbits and foxes have also been found. It’s truly sickening.

I abhor animal cruelty, and everything should be done to catch the culprit. But the minute I heard about this I began to worry — not just for the neighbourhood’s pets, but about what might come next.

The bodies of more than ten headless cats have been found dumped over the past few months — one of them, Ukiyo (pictured)

Several years ago I worked in forensic psychiatry, and I remember that a history of mutilating animals was a warning sign of profound mental disturbance.

In children, it’s associated with the child being a victim of abuse and becoming psychopaths in later life.

In adults, it’s even more worrying. There is clear evidence that people who torture and kill animals do not stop there.

It can be a precursor to attacks on humans, and some psychologists have identified spates of animal attacks as a red flag for a future child abduction in the area as the perpetrator’s behaviour escalates.

Animal cruelty is a repeated feature in the history of rapists and murderers. It is also strongly related to domestic abuse and violence.

Studies have shown that nearly 90 per cent of families where abuse is taking place also exhibit cruelty to animals.

Which raises troubling questions. Why is it down to charitable organisations such as the RSPCA to prosecute these people? Why is it that, once animal abusers have been identified and punished, no one follows it up?

Every time someone is convicted of serious animal cruelty, there should be a forensic examination of their life. Part of the sentence should be a full psychological evaluation.

Just as there is for sex offenders, so there should be a register of animal abusers. At the moment, many escape with a slap on the wrist and disappear.

We need to start seeing these crimes for what they are: a glimpse into a far darker part of someone’s soul.